Licensed Clinical/Master Social Worker

Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an affirmative action plan pursuant to the Navajo Preference in Employment Act. Pursuant to this plan and corresponding TCRHCC policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally‑recognized American Indian tribes will be given tertiary preference. Overview

POSITION SUMMARY

Incumbent serves as an Outpatient/Inpatient Social Worker for TCRHCC and/or Sacred Peaks Healthcare Center (SPHC) and is responsible for direct supervision and supportive contact for the specific group of identified high‑risk patients. The Social Worker designs and manages a continuum of care focusing on empowering clients to achieve demonstrable outcomes and self‑sufficiency. The Social Worker conducts assessment, service planning, and resource acquisition, monitors progress, and initiates and responds to emerging client needs. The Social Worker links the client with community social service providers, health‑care providers, substance abuse, and mental health providers to achieve specific goals. The Social Worker also reviews patient cases in inpatient and outpatient services, evaluates medical necessity of referrals to specialty providers, and collaborates with the multidisciplinary team to promote efficient and effective use of a variety of health‑care resources. The Social Worker works closely with providers, nurses, case managers, physicians, the PRC department, and all health‑care providers to ensure implementation of appropriate resources and fulfillment of utilization goals for the hospital and third‑party payors. The incumbent reports to the Director of Case Management/Care Coordination. Collaborates with an interdisciplinary team to assess care plans, monitor progress, and make recommendations to ensure safe and efficient hospitalizations. Responsible for evaluating patients in the ED for medical necessity and care coordination needs. Assesses potential admissions and works with advanced practice clinicians/physicians to determine appropriate admission status. Proposes and implements outpatient plans for safe discharge from the ED with physician approval. Coordinates care for patients with abuse, chronic pain, and frequent utilization issues. Interacts with patients or customers of all ages, from newborn to geriatric. As part of this they also interact with individuals who have mental health issues to help them access and navigate the resources they need to improve their wellbeing. Qualifications

NECESSARY QUALIFICATIONS

Education: Master’s degree in social work (MSW) License/Certification: Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW), valid, current, full and unrestricted professional license to practice in any U.S. state, the Commonwealth of Puerto Rico, or a U.S. territory. Must maintain a current Basic Life Support (BLS) certification by the American Heart Association throughout employment. Experience: Minimum of three (3) years’ experience in a clinical care setting. Experience and knowledge of discharge planning, case management, or utilization review processes. Demonstrated knowledge of electronic health record systems. Other Skills and Abilities: Positive working relationships with others. High ethical standards, no history of complaints. Reliable and dependable; reports to work as scheduled without excessive absences. Effective verbal & written communication skills. Team management focuses on promoting a positive and proactive approach to problem resolution. Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers. Completion of satisfactory and above‑satisfactory scores on all job interviews, demonstrating that the applicant can perform the essential functions of the job. Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating the applicant is qualified to be employed by TCRHCC. Submission of all required employment‑related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC. Mental and Physical Effort Reasonable accommodation may be provided to enable individuals with disabilities to perform the essential functions of this job. Physical: High energy, flexible schedule to meet management requirements. Ability to sit at a desk and in meetings for long periods, frequently use personal computer. Ability to walk frequently, bend, kneel, crouch, twist, maintain balance, and reach. Ability to hear, speak, and comprehend over telephone and in person. Ability to lift, push, and pull up to 50 lbs frequently. Adequate visual and hearing capabilities for reading, typing, and telephone use. Mental: Independent judgment and analytical skills to make decisions that impact operations, finances, and customer service. Ability to perform in structured and unstructured environments. Attention to detail and ability to propose practices to enhance customer satisfaction. Ability to concentrate, handle multiple priorities in stressful situations, demonstrate patience, adapt to shift work, and manage altercations calmly. Environmental: May be exposed to chemical agents, extremes of temperature or humidity, infectious diseases, dust, fumes, gases, hazardous or moving equipment, and loud noises. Responsibilities Coordinate service‑specific assessments, service planning, and enrollment. Work with all facets of the case management continuum (social support, alternate resources, community referrals, discharge planning, nursing home / skilled nursing placement, and resource utilization). Comprehensive and client‑centered service planning and coordination. Work proactively with RN case managers and social workers of TCRHCC as a team member for patient care coordination. Facilitate resource acquisition, referrals, and linkages. Maintain consistent case consultation with all direct service providers. Develop and maintain internal and external resource relationships. Monitor service and follow up to ensure continuity of care and update client service plans. Identify patients through consultation and high‑risk diagnoses (e.g., COPD, CHF, OM). Perform UR coordination functions to ensure medical necessity of preadmission, admission, continued stay, cost containment, and discharge planning for patients admitted to TCRHCC. Accountable for education, knowledge, and processes related to the Recovery Audit Contractors role in inpatient and outpatient reimbursement as related to impact on TCRHCC revenue. Lead for UR committee reviews of inpatient admissions for medical necessity, in collaboration with the medical staff representative. Assist with development of department reports, policy/procedures manuals, and program objectives. Assist with special projects as assigned. Conduct system and procedural efficiency evaluation to determine progress, performance, and conformity with program requirements. Assist in managing outpatient referrals for purchased referred care (PRC). Follow up on outside inpatient referrals for continued follow up (appointments and PHN referrals). Provide coverage for inpatient units (ACU, PEDS, ICU, OB, ER) and outpatient clinics, managing care of prioritized TCRHCC/SPHC outpatient/inpatient based on provider consultation. Collaborate with public health nursing (PHN), patient benefit coordinators (PBC), utilization review (UR), and purchased referred care (PRC) at TCRHCC/SPHC. Facilitate communication and coordination among health‑care team members, involving clients in decision‑making to minimize fragmentation in services. Develop care and service delivery plans with patients/family and multidisciplinary teams, ensuring consistent case consultation. Provide service monitoring and follow‑up to ensure continuity of care and update client service plans. Prepare patients and families for discharge from case management when services are no longer required, arranging ongoing support/direct care services post‑discharge. Be familiar with Advance Directives and serve as a resource person for patients and families, facilitating informed choice, consent, and decision‑making. Promote use of evidence‑based care, as available, in conjunction with MCG Care Guidelines. Pursue professional excellence and maintain competence in practice. Serve as the outpatient/inpatient coordinator: primary contact for outpatient/inpatient bed acquisition within and outside TCRHCC/SPHC. Collaborate with provider and nursing personnel to ensure seamless admissions. Ensure admission documentation and referrals for third‑party resources are complete prior to patient departure. Commit to case management services and assignments with purchased and referred care (PRC) and aid the PRC case specialist. Share in coverage across all units (inpatient and outpatient) for staffing shortages. Incumbent required to take call on scheduled weekends as deemed necessary. Ensure proper PPE is worn while on duty, including face mask, gloves, gown, isolation gown, NIOSH‑approved N95 filtering facepiece respirator or higher, and eye or face shield. Perform safe donning and doffing of PPE and discard used PPE accordingly. Complete routine cleaning and decontamination processes for contaminated surfaces to ensure high level of patient, visitor, employee, and external customer satisfaction. Perform other duties as assigned. #J-18808-Ljbffr Tuba City Regional Health Care Corporation